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NPI Code Detail

MEDICARE: J. R. BEK, D.D.S., P.C.

MEDICARE: J. R. BEK, D.D.S., P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry0401007256VA

General Provider Information

NPI Number : 1376647859
Entity Type Code : Organization
Provider Name (Legal Business Name) : J. R. BEK, D.D.S., P.C.
Provider Business Mailing Address
First Line : 1767 PRINCESS ANNE RD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-3835
Country : US
Telephone Number : 757-426-6151
Fax Number : 757-426-6235
Provider Business Practice Location Address
First Line : 1767 PRINCESS ANNE RD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-3835
Country : US
Telephone Number : 757-426-6151
Fax Number : 757-426-6235
Authorized Official
Title or Position : DIRECTOR
Name : DR. JEFFREY RANDALL BEK
Credential : D.D.S.
Telephone Number : 757-426-6151
Provider Enumeration Date : 09/12/2006
Last Update Date : 12/12/2012

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